Individual
HEIDI ANN MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5308 SE RHONE ST, PORTLAND, OR 97206-2962
(503) 775-6885
Mailing address
9813 SE 32ND AVE, MILWAUKIE, OR 97222-6423
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
22823
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22823
OREGON BOARD OF MASSAGE THERAPISTS
OR
Enumeration date
12/22/2016
Last updated
12/22/2016
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